Efficacy of systemically-oriented psychotherapies in the treatment of perinatal depression: A meta-analysis

Department of Family and Child Sciences, College of Human Sciences, The Florida State University, 225 Sandels Building, Tallahassee, FL, 32306-1491, USA, .
Archives of Women s Mental Health (Impact Factor: 2.16). 11/2013; 17(1). DOI: 10.1007/s00737-013-0391-6
Source: PubMed


The objective of this meta-analysis was to examine the efficacy of systemically oriented psychotherapy treatments for depression in pregnancy and the postpartum. Specifically, this synthesis examined standardized mean differences between pre- and posttest and treatment-control conditions in depression symptom reduction among 24 individual interpersonal psychotherapy or relational psychotherapy studies completed between 1997 and 2013. Analyses assessed heterogeneity, potential moderators, and publication bias. Random-effects analyses revealed a large, positive average effect size [Formula: see text] for psychotherapy treatments among one-group, pre-post-studies and a medium, positive average effect [Formula: see text] when treatments were compared with control groups. Mixed-effects meta-ANOVAs indicated that treatment type, participant depression severity, and method of depression assessment were significant moderators such that effect sizes were larger among individual interpersonal psychotherapy studies, clinical samples, and studies that included an independent evaluation of depression. However, relational treatments and studies with nonclinical samples were less represented in the literature, and still demonstrated small to medium positive effects. Meta-regressions revealed that effects were largest when treatments were delivered with adherence fidelity checks and over more sessions. Based on funnel plots and Egger tests, there was evidence of publication bias in this analysis; however, the effects were distributed fairly symmetrically about the mean given the relatively small number of available studies. Findings have implications for continued examination of systemically oriented psychotherapy treatments for depression in pregnancy and the postpartum.

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    • "It is therefore surprising that there has been so little investigation of the effectiveness of relational therapies (focused on marital and family problems) for treating antenatal depression. One meta-analysis reviewed earlier showed lower effect sizes with relational therapies than IPT in women with antenatal depression;53 however, it seems reasonable that cases of maternal depression in which marital and family problems contribute heavily to depressive symptom burden may also stand to benefit most from these interventions as well as IPT. The effectiveness of psychodynamic psychotherapy and psychoanalytic approaches in this population is described only in case literature.61 "
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